Prognostic value of gross tumor volume delineated by FDG-PET-CT based radiotherapy treatment planning in patients with locally advanced pancreatic cancer treated with chemoradiotherapy

Radiation Oncology

Ugur Selek²  Mehmet Reyhan¹  Cem Onal³  Erkan Topkan³  Cem Parlak³ 

[1] Baskent University Adana Medical Faculty, Department of Nuclear Medicine, Kisla Saglik Yerleskesi, Adana, Turkey;American Hospital- University of Texas M.D. Anderson Radiation Oncology Center, Istanbul, Turkey;Baskent University Adana Medical Faculty, Department of Radiation Oncology, Kisla Saglik Yerleskesi, Adana, Turkey

关键词: Gross tumor volume;    FDG-PET-CT based RTP;    Chemoradiotherapy;    Locally advanced pancreatic carcinoma;   

Others  :  1160879
DOI  :  10.1186/1748-717X-7-37

 received in 2011-12-20, accepted in 2012-03-19,  发布年份 2012

【 摘 要 】

Background

We aimed to assess whether gross tumor volume (GTV) determined by fusion of contrast-enhanced computerized tomography (CT) and 18F-fluoro-deoxy-D-glucose positron emission tomography-CT (FDG-PET-CT) based radiotherapy planning could predict outcomes, namely overall survival (OS), local-regional progression-free survival (LRPFS), and progression-free survival (PFS) in cases with locally advanced pancreas cancer (LAPC) treated with definitive concurrent chemoradiotherapy.

Methods

A total of 30 patients with histological proof of LAPC underwent 50.4 Gy (1.8 Gy/28 fractions) of radiotherapy concurrent with continuously infused 5-FU followed by 4 to 6 courses of maintenance gemcitabine. Target volume delineations were performed on FDG-PET-CT-based RTP. Patients were stratified into 2 groups: GTV lesser (GTV_L) versus greater (GTV_G) than cut off value determined by receiver operating characteristic (ROC) analysis, and compared in terms of OS, LRPFS and PFS.

Results

Median GTV delineated according to the FDG-PET-CT data was 100.0 cm³. Cut off GTV value determined from ROC curves was 91.1 cm³. At a median follow up of 11.2 months, median OS, LRPFS and PFS for the entire population were 10.3, 7.8 and 5.7 months, respectively. Median OS, LRPFS and PFS for GTV_L and GTV_G cohorts were 16.3 vs. 9.5 (p = 0.005), 11.0 vs. 6.0 (p = 0.013), and 9.0 vs. 4.8 months (p = 0.008), respectively.

Conclusions

The superior OS, LRPFS and PFS observed in GTV_L patients over GTV_G ones suggests a potential for FDG-PET-CT-defined GTV size in predicting outcomes of LAPC patients treated with definitive C-CRT, which needs to be validated by further studies with larger cohorts.

【 授权许可】

   
2012 Parlak et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 1.

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